Koşuyolu Park | Early Childhood Caries and Prevention Methods

Early Childhood Caries and Prevention Methods

Early Childhood Caries and Prevention Methods

More importance has begun to be given to the issue of protecting oral health in children, especially in the last decade, due to the increased prevalence of caries in primary teeth in children between the ages of 2 and 11.


ECD is a very dangerous form of caries, it begins immediately after dental eruption, develops on smooth surfaces, progresses rapidly and leaves a permanent effect on the dentition. Caries that affects milk teeth in babies and toddlers also causes decay in permanent teeth. Milk teeth not only play an important role in chewing and digestion, but also contribute to the growth and development of the child. Milk teeth also serve as space savers for the permanent teeth that will replace them.

Unfortunately, many children encounter cavities as early as 12 months. In children of this age, decay usually begins in the upper jaw front incisors, and then the canines and first molars are affected. Tooth decay in these teeth is very important for overall health as it can cause chronic pain, infections and other diseases in the child. A decrease in the quality of life of affected children is observed compared to their peers.


Since the milk teeth will change completely, not taking the problems that occur in these teeth seriously is the biggest mistake that can be made. Because milk teeth help growth and development by providing chewing and nutrition. Problems occurring in primary teeth cause growth and development to be negatively affected.

Milk teeth ensure a correct flow in the growth of the jawbone, and then these teeth protect the places of the permanent teeth that will replace them. Milk teeth are also extremely important for speech. Many sounds cannot be pronounced properly, especially when front teeth are missing. In addition, missing front teeth can cause serious aesthetic concerns in children and cause many psychological problems. Early loss of primary teeth due to trauma, caries, ectopic eruption (tooth eruption in an abnormal position) or other reasons may also cause unwanted movements of primary and permanent teeth that cause loss.


Although ECC is preventable, it currently affects more than 600 million children worldwide and remains largely untreated. It significantly affects the quality of life of children with this disease and their families and creates an unnecessary burden on society.

Early Childhood Caries, like other types of caries, is a dynamic disease that begins with biofilm (plaque), can persist in the presence of sugar, is considered multifactorial, and occurs with the disruption of the balance between demineralization and remineralization of dental hard tissues. Tooth decay occurs due to biological, behavioral and psychosocial factors related to the individual’s environment.

ECC has common risk factors with other non-communicable diseases caused by excessive sugar consumption, such as cardiovascular disease, diabetes and obesity. Excessive consumption of sugar causes long-term acid production from tooth-attached bacteria and a change in the composition of the oral microbiota and biofilm pH. When this situation continues, tooth structures become demineralized (dissolution of the minerals necessary for the tooth).

Caries risk assessment assists in this process by revealing the likelihood of developing new caries lesions in individual patients or groups of children. Caries risk assessment for a child is an important element that guides the prevention and management of dental caries. Community-level caries risk assessment can guide the design of public interventions and facilitate the allocation of time and resources to those who need it most.


Primary prevention includes improving the oral and dental health literacy of parents/caregivers and healthcare professionals, limiting children’s consumption of free sugars from beverages and foods, and ensuring daily use of fluoride.

Secondary prevention consists of more frequent fluoride varnish applications and pit and fissure sealant applications to molars that are susceptible to caries, in order to effectively control initial carious lesions before cavitation occurs.

Tertiary prevention includes stopping the progression of cavitated carious lesions and operative procedures to keep the teeth functional in the mouth.

If very young children have not sufficiently acquired preventive habits and ECD develops in these children, the therapeutic approach should be applied by a specialist dentist, because the treatment of ECC can be specific for each patient due to the aggressive nature of the disease. The use of anticariogenic (anti-caries) agents reduces the risk of caries development and progression. The patient’s developmental period and understanding capacity, as well as the extent of the disease, affect treatment options.


  • Family physicians should inform families about ECC and give suggestions to families in terms of preventing ECC.
  • Families should be informed that they should clean their babies’ teeth by wiping them with a piece of clean cheesecloth after breastfeeding or after feeding, and that they should repeat this process after giving medications in the form of syrup containing sugar. If they put their children to sleep with a bottle at night or during the day, they should be told that they should not put liquid foods containing sugar into the bottle and the best approach is not to give the child a bottle at bedtime. In addition, the child should not be allowed to fall asleep while breastfeeding or with a bottle, and the bottle should not be used as a pacifier. Sucking is a natural instinct for all babies. It should be noted that if the baby still needs to suckle after being fed, a pacifier or a bottle containing only water can be given.
  • For bottle-fed babies, they should be advised not to give milk or sweet drinks to the baby at bedtime, not to feed the baby for more than 30 minutes while sleeping, not to use the bottle as a pacifier, and to use cups for other liquids after the age of 1.
  • It should be noted that for breastfed babies, feeding time should not be more than 30 minutes, care should be taken to ensure that the baby does not fall asleep while breastfeeding, and feeding the baby at frequent intervals should be avoided.
  • In conclusion; Although ECD is an important health problem, it is not emphasized much because primary teeth are temporary in the mouth and their importance is not known enough.
  • Untreated ECD causes speech impairment, learning and eating problems as a result of pain and infection. Early loss of primary teeth due to ECD causes negative effects on growth and development, malocclusions (bad tooth closure), and aesthetic and psychological problems.
  • The child usually meets the dentist later than family physicians and pediatricians. For this reason, it is important for family physicians to have knowledge about ECC in order to refer the child to a specialist dentist.
Sizi Arayalım